1. Field of the Invention
This invention relates to a surgical delivery apparatus, and in particular, to an apparatus for delivering an anvil component to a remote location within a hollow organ to effect the joining of hollow organ sections by circular anastomosis.
2. Description of the Prior Art
Circular anastomosis is the surgical joining of separate hollow organ sections so that the sections intercommunicate. Typically, the anastomosis procedure follows surgery in which a diseased or defective section of hollow tissue is removed and the remaining end sections are to be joined. In accordance with such procedures, the operative tissue is exposed by making several extensive incisions in the body cavity wall and folding the cut tissue to provide access to the surgical site. The diseased section of the organ is removed thereby leaving two separate end sections of organ which are thereafter fastened by means of a stapling instrument which drives a circular array of staples through the end sections and simultaneously cores out any overlapping tissue to free the tubular passages.
Examples of such instruments for performing anastomosis of hollow organs are described in U.S. Pat. Nos. 4,304,236, 4,379,457, 4,573,468, 4,576,167, 4,603,693 and 4,646,745 all of which are incorporated herein by reference. In instruments of the types exemplified by these patents, opposed end portions of the organs to be stapled are clamped between an anvil component and a staple holding component, both of which are located at the distal end of the instrument. The clamped tissue is stapled by driving one or more staples from the staple holding component so that the ends of the staples pass through the tissue and are clinched by the anvil component.
In the typical application of joining first and second intestinal sections together, the operative tissue is accessed by forming at least one incision across the midline of the lower abdomen and folding the cut tissue to reveal the surgical site. The intestinal section in question is isolated and removed leaving the first and second intestinal end sections to be joined by anastomosis. The stapling instrument with mounted anvil component is applied to the operative site. Each end of the intestinal sections to be attached is then secured to their respective stapler or anvil component by a well-known purse string stitch to cause the tissue portions to tighten and to remain on the apparatus in position for permanent attachment by the staples. Thereafter, the anvil component is manually brought into close proximity to the staple holding component. The instrument is fired and the intestinal sections are attached by circular rows of staples or fasteners.
In some applications of the circular anastomosis technique, it is necessary to utilize a surgical instrument in which the anvil component is detachably mounted to the staple holding component. In such cases, the stapling instrument is introduced either surgically or transanally into the first intestinal section without the anvil component in place. The anvil component is subsequently surgically inserted within the second intestinal section. Both intestinal sections are secured to their respective anvil or stapler component by a drawstring. The anvil component is thereafter mounted within the staple holding component and the instrument is fired to complete the anastomosis. However, in such procedures the surgical site must be exposed by conventional surgical methods, i.e., incising of the lower section of the abdomen in order to emplace the anvil and join the tissue. This is undesirable in that it requires additional, often excessive time, causes additional trauma to the patient, and unnecessarily delays the anastomosis procedure. Further, it precludes the surgeon from using minimally invasive techniques to complete the anastomosis.
Therefore, in attaching first and second intestinal sections by circular anastomosis, it is highly desirable to prepare the intestinal sections and perform anastomosis using minimally invasive surgical techniques, particularly in situations which require the anvil component to be applied into an intestinal section independently from the stapling instrument. The present invention achieves this objective by providing a delivery system to be inserted transanally into the patient to deliver an anvil component through the intestine and to a targeted position therewithin. Thereafter, the intestinal sections can be laparoscopically severed to resect a defective or diseased tissue portion. The anvil component may be mounted within the staple holding component by laparoscopic means and the anastomosis completed.